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SAVE THE BABIES
This Pamphlet was Prepared by
L. EMMETT HOLT, M.D., LL.D.
Professor of Diseases of Children in the College of Physicians an^
Surgeons (Columbia University), New York; Attending
Physician to the Babies* Hospital
HENRY L. K. SHAW, M.D.
Clinical Professor of Diseases of Children in Albany Medical College
(Union University), Albany, N. Y.; Attending Physician to
St. Margaret's Hospital for Infants; Director of the
Division of Child Hygiene, New York State
Department of Health
" ~ - ^ '
American Medical Association
Five Hundred and Thirty-Five North Dearborn Street
American Medical Association
I. BEFORE THE BABY COMES
Motherhood should cause no fear of trouble.
Giving birth to a baby is natural and normal.
As soon as you know a baby is coming, engage the
best doctor you can afford and place yourself under
If you had one miscarriage, another may be pre-
vented by proper treatment.
If you cannot afford a doctor, apply to a hospital or
dispensary where experienced doctors and nurses will
advise and care for you.
A nervous, overworked, underfed woman cannot
expect to have a strong, vigorous healthy child.
The expectant mother requires an extra amount oi
sleep, and a day-time rest for an hour or two is desir-
able. She should keep the windows open while she
Much climbing of stairs and the use of the sewing
machine should be avoided during the later months of
Hard household or factory work during the later
months of preganacy tend to bring on miscarriages,
or to make the child small and delicate.
When labor is threatened before the proper time,
the expectant mother should go to bed at once and
remain perfectly quiet until the danger is over.
Walks in the open air should be taken during the
entire course of pregnancy. Exercise in the fresh air
and housework with the windows open are better than
Violent exercise in any form should be avoided.
Daily bathing is necessary for the best health of
At least one satisfactory movement of the bowels
should take place every day; if there is any difficulty
about this, the doctor should be consulted, for it is
It is necessary to drink plenty of water so that the
kidneys will act freely.
Loose, comfortable clothing is essential to the com-
fort of the mother and the welfare of the child. Skirts
and dresses should hang from the shoulders; but no
tight bands about waist or chest.
Breasts and nipples should be kept clean and
softened with a little vaseline each day ; this will make
the act of nursing one of pleasure and satisfaction
instead of one of pain and discomfort.
Expectant mothers must have plenty of simple
nourishing food ; the baby must not be starved before
it is bom. Tea and crackers will not make milk and
strength. Also, highly seasoned, rich and fried foods
should be avoided.. Overeating surely taxes the organs
which care for waste materials and may cause serious
DIET FOR MOTHERS
The following diet is recommended during preg-
nancy and nursing.
All kinds of soups.
All kinds of fresh fish, boiled and broiled.
Meats — once a day — beef, mutton, lamb, veal,
ham, bacon, chicken or turkey.
Eggs — freely, one or two each day.
All cooked cereals with milk and cream and sugar
All stale breads, avoiding fresh bread and rich
All green vegetables — peas, string-beans, aspar-
agus, cauliflower, onions, 'spinach, white and sweet
potato, celery, lettuce and other plain salads with oil.
Desserts of plain custard or pudding, ice cream;
Fruits should be freely taken ; all ripe raw fruits
and cooked fruits.
Drinks — milk, buttermilk, cocoa and plenty of
water, one or two quarts daily ; tea and coflfee spar-
ingly and not strong, once a day. No beer or other
II. WHAT TO PREPARE
NECESSARY THINGS FOR THE BABY
Three-quarter yard thin, light-weight flannel.
Two light-weight woolen blankets.
Three cotton and wool undershirts.
Three flannel skirts.
Three outing flannel gowns.
Four cotton slips.
One and one-half dozen diapers, 18 inches.
One and one-half dozen diapers, 22 inches.
One box boric acid.
One box talcum powder.
One piece Castile soap.
One-quarter pound sterile gauze.
One-quarter pound sterile absorbent cotton.
Two dozen safety pins, large and small.
One set of scales.
NECESSARY THINGS FOR THE MOTHER
One and one-half yards square oil cloth or rubber
Two pounds absorbent cotton.
Two pounds sterilized gauze or equivalent in old
III. THE NEW-BORN BABY
There should be a warm, soft blanket to receive him.
The body should be oiled, not bathed.
The eyes should be carefully cleansed with a satu-
rated solution of boric acid, and into each eye the
doctor or nurse should put two or three drops of a
2 per cent, solution of nitrate of silver to prevent sore
eyes and possibly blindness.
He should be placed in a quiet, darkened room,
properly protected against the cold but not sur-
rounded with too many hot water bagfe or bottles.
He should not be put to the breast for five or six
During the first twenty-four hours the baby should
not nurse more than four times, but both breasts each
time. If he cries much, he should have boiled water,
but not any kind of tea, nor sugar and water.
Beginning with the third day, when the milk usually
comes, he should nurse regularly every three hours,
alternating the breasts, or taking both breasts each
time according to his appetite and the amount of milk
secreted. He should not remain at the breast more
than twenty minutes in all.
Nursing times should be regular by the clock;
tegular feeding means regular sleep and these things
make the care of the baby much easier.
In the beginning it is well to waken the baby at
nursing time ; soon he forms the habit of waking him-
self at the regular interval.
In case the milk is delayed longer than the third day,
the baby should be fed at three-hour intervals, but
he should be regularly put to the breast first in order
to stimulate the flow of milk.
IV. REASONS WHY YOU SHOULD
NURSE YOUR BABY
Breast milk is always ready and is never sour.
Breast milk does not have to be prepared or mea-
It is Nature's method and was intended for your
It will make your baby strong and healthy.
It is absolutely free from germs and dirt.
It protects your baby from many infants' diseases.
It is §afer for the baby. Ten bottle-fed babies die
to one fed on the breast.
It is the only perfect food for the baby.
It contains the proper elements of food in the right
proportion for' the growing child.
Breast-fed babies seldom have bowel trouble, which
is so fatal in bottle-fed babies, especially during hot
Your baby will have the best chance of living if it
is breast fed.
V. ADVICE TO NURSING MOTHERS
Keep yourself well. As long as you are well, your
baby will probably be well.
Don't get discouraged if you have but little milk
at first. Feed the baby a little from the bottle after
nursing when necessary; but do not give up nursing.
Be patient and try again.
Eat plain, nutritious food. Avoid salads, pickles
and spicy foods.
Drink plenty of water and milk. Avoid tea, coflfee
and alcoholic beverages.
Nurse the baby regularly. Feed him by the clock
and not longer than twenty minutes at one time.
Until he is four months old, nurse every three hours
up to 10 p. m. and only once during the night ; seven
nursings in twenty-four hours.
After he is four months old, omit all night nursings ;
give but six nursings in twenty- four hours.
When six months old, nurse every four hours
(usually giving both breasts each time) ; only five
nursings in twenty- four hours.
When the baby cries between feedings, give him
cooled, boiled water without anything in it.
Do not wean or give any other feeding without con-
sulting a doctor.
VI. WEANING FROM THE BREAST
If a mother becomes pregnant, or has any serious
or severe acute illness, the baby should be weaned.
Under other circumstances, if the baby is thriving,
the nursing should be continued for nine or ten months
without other food.
Weaning should be done gradually, if possible, by
giving the baby at first one, and later two or more
feedings from the cup or bottle in place of a nursing.
The number of feedings should be gradually
increased until the baby is taken entirely from the
breast at eleven or twelve months.
If the baby is weaned before eight months he should
be taught to take the bottle ; if at ten or eleven months
old, it is better to teach him to drink or feed from
If possible, weaning during the summer months
should be avoided.
VII. ARTIFICIAL OR BOTTLE-FEEDING
There is no perfect substitute for breast milk.
Clean fresh cow's milk properly modified is the
best substitute available.
Patent foods should be avoided ; they are not fresh ;
they are expensive, and the babies fed on them are
more liable to be sick than those fed on cow's milk.
CARE OF THE MILK
Buy only clean milk, from a clean milkman and keep
it clean in your home.
Buy for the baby the freshest milk you can get,
but not the richest milk.
If possible, only milk delivered in bottles should
Dipped milk is never clean and never quite safe ;
dirt and flies are likely to get into it.
If such milk is used, it should always be kept
When received, the milk should be put immediately
on ice and kept there. Warm milk readily spoils and
spoiled milk will make the baby sick.
One should never leave an open pitcher out of doors
for the milkman to pour milk into.
One should never allow milk to stand about the
house in open vessels nor on the steps in the sun.
Not only the bottles and dishes used, but the hands
of the mother should be very clean before preparing
New rubber nipples should be boiled. All nipples
after using should be carefully washed in soap and
water "and kept covered in a glass containing boric
acid or baking soda and water. They should be rinsed
Bottles should be rinsed when emptied and then
kept filled with water. Before preparing the food for
the day they should be thoroughly washed with hot
suds and placed for ten minutes in boiling water.
During the summer the milk should always be boiled
or pasteurized. Boiling milk kills the germs and makes
the milk safer.
In preparing the milk for the baby it is easier to
fix the entire supply for the day at one time. The
proper quantity for each feeding is put in a separate
The milk may be pasteurized by placing these bot-
tles in a deep saucepan filled with cold water and
left on the stove until the water boils. Then remove
from the stove to a table and allow the bottles of
milk to stand in the hot water for twenty minutes.
Then cool by placing them in cold water, afterwards
putting them on ice. Rapid cooling is of great impor-
When milk is boiled, this should be done in the
separate feeding bottles after it is prepared.
A HOME-MADE ICE BOX
This may be made as follows: Get from your
grocer a deep box about 18 inches square and put
3 inches of sawdust in the bottom. Place two pails
in this box, one, a smaller pail, inside the other, and
fill the space between the outer pail and the box with
sawdust. The nursing bottles filled with milk are
placed in the inner pail. This pail is then filled with
cracked ice which surrounds the bottles. The inner
pail should have a tin cover. Nail several thicknesses
of newspaper on the under surface of the cover of
the box. This ice-box should be kept covered and
in a shady, cool place. The water from melted ice
'should be poured off and the ice renewed at least once
• PREPARATION OF THE FOOD
The simplest plan is to use whole milk (from a
shaken bottle) which is to be diluted according to
the child's age and digestion.
Beginning on the third day, the average baby should
be given 3 dunces of milk daily, diluted with 7 ounces
of water. To this should be added one tablespoonful
of lime water and two level teaspoonfuls of sugar.
This should be given in seven feedings.
At one week, the average child requires 5 ounces
of milk daily, which should be diluted with 10 ounces
of water. To this should be added one and a half
even tablespoonfuls of sugar and 1 ounce of lime
water. This should be given in seven feedings.
The milk .should be increased by i/^ ounce about
every four days.
The water should be increased by ^ ounce about
every eight days.
At three months, the average child requires 16
ounces of milk daily, which should be diluted with
16 ounces of water. To this should be added three
tablespoonfuls of sugar and 2 ounces of lime water.
This should be given in six feedings.
The milk should be increased by ^ ounce about
every six days.
The water should be reduced by y^ ounce about
every two weeks.
At six months, the average child requires 24 ounces
of milk daily, which should be diluted with 12 ounces
of water. To this should be added 2 ounces of lime
water and 3 even tablespoons ful of sugar. This should
be given in five feedings.
The amount of milk should be increased by ^ ounce
The milk should be increased only if the child is
hungry and digesting his food well. It should not be
increased unless he is. hungry, nor if he is suffering
from indigestion even though he seems hungry.
At nine months, the average child requires 30 ounces
of milk daily, which should be diluted with 10 ounces
of water. To this should be added two even table-
spoonfuls of sugar and 2 ounces of lime water. This
should be given in five feedings.
The sugar added may be milk sugar or if this cannot
be obtained cane (granulated) sugar or maltose
At first plain water should be used to dilute the
At three months, sometimes earlier, a weak barley
water may be used in the place of plain water; it is
made ^ level tablespoon ful of barley flour to 16
ounces of water and cooked for twenty minutes.
At six months, the barley flour may be increased
to 1^ even tablespoon fuls, cooked in the 12 ounces of
At nine months, the barley flour may be increased
to 3 level tablespoonfuls, cooked in the 8 ounces of
A very large baby may require a little more milk
than that allowed in these formulas.
A small or delicate baby will require less than the
milk allowed in the formulas.
RULES FOR FEEDING
Rules for bottle feeding must be carefully observed :
regularity is very important.
From the outset the babv should not be fed oftener
than every three hours up to 10 p. m. and one feeding
later during the night; only seven feedings in the
twenty- four hours.
After four months no night feeding after 10 p. m.
should be given ; only six feedings in the twenty- four
After six months the time between feedings should
be made four hours and only five meals given in the
The bottle should always be held while the child is
taking his food.
After feeding, the child should be placed upright
and patted to allow him to bring up the gas, generally
air which he has swallowed. He should then be placed
in his crib, but not rocked.
A child should never be played with after feeding.
He should not be allowed to suck on an empty bottle.
He should not be allowed to sleep with the nipple
in his mouth.
If a child does not take all his feeeding, what is left
should be thrown away; never warmed over again
for a later feeding.
Unless a child has loose bowels he should be given
from one to three tablespoon fuls of strained fruit juice
once a day after he is seven or eight months old.
After he is nine months old, he may be given
squeezed beef juice, beef tea or plain mutton or chicken
broth, once a day.
When he is ten months old, he may have part of
a soft egg, a small piece of crisp toast or zwieback
or a crust of bread to chew, immediately after his
Other solid foods should not be given during the
At twelve months, he may take his milk undiluted
and strained cereal may be given twice a day.
VIII. FROM THE BOTTLE TO TABLE
During the second year, the child should have four
meals a day ; hours : 6 a. m., 10 a. m., 2 p. m., 6 p. m.
Nothing but water should be allowed between his
At twelve months, the baby should be weaned from
the bottle and taught to drink milk from a cup.
He may then have cereals twice a day which should
be thoroughly cooked and for the first two or three
months they should be strained.
He should have four cups of milk daily.
When fifteen months old, he may have at first a
teaspoonful, later one tablespoonful of rare scraped
beef, mutton or chicken.
When eighteen months old he may have one-half of
a mealy baked potato daily.
When two years old, he may have most of the fresh
green vegetables when thoroughly cooked and finely
Tea, coffee, cider, wine, beer, soda-water and candy
should never be given to a young child.
The juice of fresh fruits may be given after twelve
Cooked fruit, such as baked apple or applesauce,
should be given once a day after a child is eighteen
months old; it should at first be strained.
Stale, raw fruits are especially dangerous in the city
and in the summer.
TWO TO THREE YEARS.
Breakfast — 7:50 A, M.
The juice of one sweet orange or the pulp of four
or five stewed prunes, or applesauce.
Either a well-cooked cereal: corn meal, Petti John,
oatmeal, cracked wheat, wheatena, all well salted and
not more than one-half teaspoonful of sugar, and milk
added ; or soft boiled or poached egg with stale bread
or crisp toast.
Glass of warmed milk.
10:30 A. M,
Glass of warmed milk.
Dinner — /;jo to 2 P. M,
One-half cup of broth or soup, which may be
chicken, beef or mutton, thickened with barley or rice.
Chop, rare roast beef, rare steak, or chicken or
Boiled or baked potato.
Asparagus tips, carrots, string teans, peas, spinach.
All vegetables should be very thoroughly cooked and
Dessert: baked apple, plain bread or rice pudding,
corn starch, custard, junket, or stewed prunes with
Supper — 5:30 P. M.
Well-cooked cereal, or bread and milk, or bread and
butter and cocoa, and stewed fruit, applesauce.
Glass of warmed milk.
No food between meals. Water several times a day.
X. THINGS WHICH ARE BAD FOR ALL
Whisky or gin for supposed colic.
Dirty playthings, dirty nipples, dirty bottles, dirty
Waterproof diapers except for temporary use.
Moving picture shows.
Violent rocking, bouncing and rollicking play at
Play of every sort after feeding.
Kissing the baby on his mouth either by the family
or by strangers.
Testing the temperature of the baby's milk by taking
the nipple in the mouth.
Sucking on empty bottles.
Sleeping on the mother's breast while nursing.
Sleeping in bed with the mother.
Spitting on handkerchief to remove dirt from baby's
Sneezing and coughing in the baby's face.
Allowing a person with a cough or cold to hold
Allowing any person with tuberculosis to take care
of the baby.
The baby is not a toy or a plaything, but a great
responsibility — its health, growth and happiness depend
largely on you.
XL THE SUMMER CARE OF BABIES
THE BREAST-FED BABIES
Breast milk is the best milk for the summer.
Breast-fed babies seldom have severe diarrhea.
If they vomit or have acute indigestion it is usually
because they are fed too much or too often, or because
the mother is so sick or tired out that her milk is poor.
In very hot weather the baby should nurse less
Give him the breast only every four hours, but give
cooled boiled water freely between the nursings.
THE BOTTLE-FED BABIES
They are much more likely to get diarrhea.
If they have diarrhea it is much more often severe.
The milk must be clean and be kept cold.
' It should be boiled or pasteurized.
The bottles and rubber nipples should be boiled daily
and kept very clean.
In very hot weather the baby needs less food but
more to drink. His milk should therefore be diluted
with boiled water and cooled boiled water given freely
It is easier to prevent diarrhea than to cure it.
The important means of preventing severe diarrhea
1. Boil all milk in summer.
2. Dilute the baby's food in very hot spells.
3. Stop the food at once if an acute diarrhea begins.
If the movements become loose and only two or
three a day, do not neglect it because the baby happens
to be teething ; it may mean the beginning of a serious
Dilute the food with an equal amount of boiled
water and give less than the usual amount at a feeding.
If the movements are more frequent and there is
vomiting or fever, stop all food at once and give only
boiled water, and call a doctor.
After twelve hours without food, barley water,
made one tablespoon ful to one pint, may be given.
Proper treatment at the beginning of a diarrheal
attack is worth more than many days' treatment later.
The clothing in hot weather should be light and on
very hot days only the shirt, band and napkin worn.
Bathe the baby morning and evening and on hot
days also in the middle of the day.
Keep the skin clean and well powdered.
Napkins when soiled should be placed at once in
water and washed as soon as possible.
The baby needs fresh air quite as much as fresh
Keep him out of doors as much as possible.
Avoid the sun on hot days.
In very hot weather take him out early in the morn-
ing and in the late afternoon and early evening.
It is often cooler in the house, with shutters closed,
in the middle of the day.
Take the baby to the park, to the beach and to the
country whenever you can.
Keep the room free from soiled clothes and rubbish.
Do not let the baby play with cats or dogs. Cats
and dogs carry diseases to babies.
Do not let the baby crawl around on a dirty floor or
dusty carpet. Place him on a clean sheet or blanket.
Keep playthings and pacifiers out of his mouth.
Flies carry disease to babies. Screen the baby's
Keep flies away from the baby and his food at all
Cover the crib or carriage with netting to keep out
the flies and mosquitoes.
To avoid fine, this book sliouid be returned oo
or before the date last stamped below
P61 Holt, L.E. //^^^H
H77 Save the babiesj/ ^|
1916 / M
NuiE y" ^^^^1